Protocols and algorithms likely drive the majority of decisions a medic will ever make. Past that you may have unit or service SOPs. If you find yourself in a situation, such as a prolonged field care situation, that outlasts all of those you should know

some of the current best practices and data to back up your decisions you may be forced to make. Dogma is believing something to be true without knowing if it actually is, or why. Don’t rely on dogma, question things and have your own opinions. Know why you believe what you believe. When you make a telemedicine consult call you should have a fairly good idea of the decision you are leaning toward and why. You will sound much more like the medical professional you claim to be and less like the knuckle dragger they may be expecting. Medicine is a separate language and you are expected to be somewhat fluent. Data and research are intellectual and professional currency and which can add to your credibility. Read an article, understand who the authors are, their specialty, where they work and who funded or sponsored it as well as the references at the end. You will run across words you aren’t familiar with. Put them in the Google machine and expand your medical vocabulary. You may even want to read those references and the references to those in order to really dig deeper. (Three deep, right Scott?) Podcasts are a great way to hear opinions on some of these studies and how others have incorporated them into their practice. Podcasts and blogs (even this one) are not journal articles and studies. They are meant to raise discussions and spark debate and make you aware of new techniques or practicees. If a study is mentioned find the article and read it yourself. Don’t be the guy quoting a podcast or Facebook post in a scholarly discussion, at that point it will just be entertainment, for the other guy. Know where it originated.

Our working group has published 7 official position papers and numerous other recommendations you can read by clicking the links to the right. These are usually written by subject matter experts and edited by the working group at large and they often have references listed at the end. I encourage you to dig deeper and read what we are reading and using to make recommendations. If your in the US Military, you have access to the vast majority of publications and databases. Go find your post librarian, they are usually happy to help. If you are not, you may want to talk to your medical director and see what is available or even start investing in your own medical education by subscribing to some of the relevant journals. In order to get started I posted the entire journal watch list as well as the TCCC abstract list from the CoTCCC below to read here or download. I don’t hesitate to include the TCCC material because everything we adopt from TCCC will affect how you approach prolonged field care to some degree. I will be keeping a separate page of these scholarly references so please comment below and share what you are reading so we can quickly build up a reading list.

I challenge you to copy and paste a couple of the articles below into your search engine and see how easy it can be to get this information and improve yourself and your understanding of your craft.

Get yourself added to the TCCC email list by sending a request to danielle.m.davis.civ@mail.mil. These lists are put out by the president of the CoTCCC, Frank Butler, as a service to medics and providers to increase their knowledge and awareness of current research.

Schauer S, Bellamy M, Mabry R, Bebarta V: A comparison of the incidence of cricothyrotomy in the deployed setting to the emergency department at a level I military trauma center: a descriptive analysis. Mil Med 2015;180:60-63

Committee on Gulf War and Health;Long-Term Effects of Blast Exposures; Board of the Health of Select Populations; Institute of Medicine. Gulf War and Health, Volume 9: Long-Term Effects of Blast Exposures 2014. National Academies Press

Kongsgaard U, Eeg M, Greisen H: The use of Instanyl® in the treatment of the breakthrough pain in cancer patients: a 3-month on observational, prospective, cohort study. Support Care Cancer 2014;Epub ahead of print

Chesters A, Keefe N, Mauger J, Lockey D: Prehospital anaesthesia performed in a rural and suburban air ambulance service staffed by a physician and paramedic: a 16-month review of practice. Emerg Med J 2013;Epub ahead of print

Seghatchian J, Samama M: Massive transfusion: an overview of the main characteristics and potential risk associated with substances used to correction of coagulopathy. Transfus Apher Sci 2012;Epub ahead of print

Semple E, Bowes-Schmidt A, Yi Q, et al: Transfusion reactions: a comparative observational study of blood components produced before and after implementation of semiautomated production from whole blood. Transfusion 2012;Epub ahead of print

Beckett A, Savage E, Pannell D, et al: Needle decompression for tension pneumothorax in Tactical Combat Casualty Care: do catheters placed in the midaxillary line kink more often than those in the midclavicular line? J Trauma 2011;71:S408-S412

Lundy J, Cancio L, King B, et al: Experience with the use of close-relative allograft for the management of extensive thermal injury in local national casualties during Operation Iraqi Freedom. Am J Disaster Med 2011;6:319-324

Maureen M, York G, Hirshon J, et al: Trauma readiness training for military deployment: a comparison between a U.S. trauma center and an Air Force theater hospital in Blad Iraq. Mil Med 2011;176:769-767

Letson H, Dobson G: Small volume 7.5% NaCI with 6% Dextran-70 or 6% and 10% hetastarch are associated with arrhythmias and death after 60 minutes of severe hemorrhagic shock in rat in vivo. J Trauma 2010;Epub ahead of print

Sheppard F, Keiser P, Craft D, et al: The majority of US combat casualty soft-tissue wounds are not infected or colonized upon arrival or during treatment at a continental US military medical facility. Am J Surg 2010;200:489-495

Lew T, Walker J, Wenke J, et al: Characterization of craniomaxillofacial battle injuries sustained by the United States service members in the current conflicts of Iraq and Afghanistan. J Oral Mazillofac Surg 2010;68(1):3-7

Kaspar R, Griffith M, Mann P, et al: Association of bacterial colonization at the time of presentation to a combat support hospital in a combat zone with subsequent 30-day colonization or infection. Mil Med 2009;174:899-903

At my shop, one of our attendings “encourages” the residents and PAs to ask “why”. It helps one to understand what they really don’t know if they cannot answer the question. Also he would allow the trauma team to do just about anything within reason if we had a paper to back up our actions.

Best app ever that helps you stay on top of the most recent developments in your area of interest http://www.qxmd.com/apps/read-by-qxmd-app
It’s free! Pick your journals, pick your keywords, and let the goodness flow…

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The materials and comments published on prolongedfieldcare.org are unofficial expressions of opinion; views are those of the authors and not necessarily those of the US Army Special Operations Center of Excellence, Department of the Army, the Department of Defense, or any agency of the US (or any other) government.
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